Friday, March 20, 2015

The intimate link between trauma and dissociation

I believe that traumatic experience is different from trauma, it does not necessarily lead to what we call trauma. Browne (1990) defines trauma as “unexperienced experience” and I agree with this definition. For an experience to remain unexperienced, or for trauma to occur, dissociation has to be present, as it is the mechanism by which an experience remains unexperienced. This is why chronic or persistent dissociation always results in trauma.

Why does an experience remain unexperienced? Because it has overwhelmed our coping mechanisms, we can’t process or feel it, so, as Browne says “instead of a way of avoiding external danger, it [dissociation] is now utilised to deal with the threat of internal destabilisation; whenever we are faced with an overwhelming experience that we sense as potentially disintegrating, we have the ability to suspend it and “freeze” it in an unassimilated, inchoate form and maintain it in that state indefinitely, or for as long as necessary”.

An overwhelming experience can be an external (any type of abuse for example) or internal (the way we perceive or appraise an experience) threat. Therefore there is no such thing as an objective stressor, if the symptoms of trauma are present, and there are many, not just the obvious ones like PTSD, we can say that someone is traumatised.

Some have asked whether peritraumatic dissociation can lead to trauma. While it does not necessarily lead to trauma because it is usually a temporary response, the exception seems to be the involuntary tonic immobility response (more commonly known as the freeze response). Tonic immobility is a somatic dissociative response that protects against overwhelming threat that could result in death. If not discharged, this usually temporary response can also become persistent and chronic leading to trauma.

Some researchers have argued that tonic immobility is inherently traumatic (Bovin, 2011), however Levine (2010) disagrees. He believes that it is the coupling of tonic immobility with intense emotions such as fear that renders the response traumatic. In fact, this forms the basis for Levine’s theory of trauma. That said, some trauma sufferers report that the experience of tonic immobility has been very overwhelming for them.

For example not being able to call out for help or being rendered physically immobile can feel very helpless. Then there are the appraisals of these same behaviors, such as “I should have fought back” or “I am so ashamed I just lay there”, which can also be extremely traumatising. Some of the reasons for these responses may be that tonic immobility is not as widely known or understood as the flight or fight responses. So many may be confused and/or shocked when they become immobile and can’t do or say anything. We also seem to have lost or shunned our connection with our evolutionary past and instincts. Therefore, it can be difficult to understand and accept survival behaviours such as tonic immobility.

Culturally, many of us are taught to fight when faced with threat, so there is a lot of criticism for rape survivors for example if they haven’t fought back. In fact, many times the perpetrator might not even be prosecuted because evidence of a struggle was not found. It is any wonder then that this response is so misunderstood? Tonic immobility is also referred to as “passive resistance or avoidance” many times in the psychological literature which I think is a derogatory and superficial evaluation and could in fact give impetus to appraisals such as “I should have fought back” or “I’m weak and to blame”.

Have we simply lost the ability to experience and discharge tonic immobility because of the cultural cage we live in that disowns many, if not all, of our survival instincts, particularly those pertaining to the body? Animals in the wild freely discharge the enormous survival energy that the response generates without feeling fear, helplessness or shame, which also ensures their survival. Maybe we should (re)learn something from them?

1 comment:

Paul F. Dell's blog is a great resource on trauma and dissociation. You could start off by reading this post https://understandingdissociation.wordpress.com/2010/09/17/the-evolutionary-link-between-trauma-and-dissociation/

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